Healthcare Provider Details

I. General information

NPI: 1376528091
Provider Name (Legal Business Name): RONALD T. STEPHENS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USAG-JAPAN UNIT 45011
APO AP
96338
JP

IV. Provider business mailing address

USAG-JAPAN, UNIT 45013 BOX 2643
APO AP
96338
JP

V. Phone/Fax

Practice location:
  • Phone: 01181428694546
  • Fax:
Mailing address:
  • Phone: 01181428696476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number041971
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: